DR. CHARLES CAPDEVILLE PETERSON (D.O.) – Family Medicine Physician, NPI 1871036798
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
Provider Addresses for DR. CHARLES CAPDEVILLE PETERSON (D.O.)
1975 Verdugo Blvd Ste A
LA Canada Flintridge, CA 910113024
Phone: (747) 212-3441
Type: Location
544 N GLENDALE AVE STE B
GLENDALE, CA 912063311
Phone: (747) 212-3441
Type: Location
East Broadway, Glendale, Los Angeles County, California, 91206, United States
GLENDALE, CA 912051315
Phone: (818) 500-5586
Fax: (818) 500-5587
Type: Mailing
230, South Chevy Chase Drive, Glendale, Los Angeles County, California, 91205, United States
GLENDALE, CA 912054436
Phone: (818) 500-5586
Fax: (818) 500-5587
Type: Location
2100 POWELL ST STE 400
EMERYVILLE, CA 946081826
Phone: (510) 350-2600
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 29 Open Payments records for all available years, with a total value of $725.
Total Amount is formed as General ($725) + Research ($0) + Ownership ($0) = $725.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Exact Sciences Corporation ($361).
Total Amount
$725
General + Research + Ownership
Payments
29
Total payment records
General Amount
$725
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Exact Sciences Corporation | $361 |
| ABBVIE INC. | $130 |
| Merz North America, Inc. | $69 |
| Hologic Sales and Service, LLC | $58 |
| Alkermes, Inc. | $49 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-07-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180717000671 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 166 | 50 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 113 | 48 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 62 | 60 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 38 | 37 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 21 | 16 | $0 |
Insurance plans in this area (ZIP 91011)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Internal Medicine | CA |
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